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BEST OF BOTH WORLDS: HIGH-QUALITY REHABILITATION PARTNERS HELP MEET STANDARDS AND REDUCE COSTS


By William Dieter, PT, DPT, GCS, FSOAE


Argentum’s Standards for Senior Living demonstrate the industry’s commitment to quality service. Communities that collaborate with high-quality Medicare Part B rehabilitation partners get the best of both worlds: support in meeting the Standards and one- year cost savings of more than 8%.


Standard I relates to resident rights and the support of independence and dignity. Standard IV speaks to enhancing resident safety. Physical and occupational therapists as well as speech-language pathologists who are proactive, collaborative, evidence-based and skilled in the proper dosage of therapeutic interventions directly support you and your staff in adhering to those Standards. Indirectly, a quality Medicare Part B partner will have a positive impact on your staff and potential residents’ interest in your community. Standard V and VI speak to staff that is appropriately trained and skilled and addresses programming that is of interest to residents.


Your staff will benefit from a quality rehabilitation provider in two primary ways. First, collaboration helps to reduce overall frustration, wasted effort, and the risk of injury to both residents and staff. Secondly, higher functioning residents enhance staff satisfaction and turnover. A 2017 publication titled, “The National Benchmark Report 2017” outlines how current and potential residents perceive wellness programs. Wellness programs are one of the reasons residents move into a community and positively influence resident satisfaction and perception of value from the community. Residents who utilize said programs also experience a longer length of stay which is consistent with FOX Rehabilitation’s concierge wellness model.


High-quality rehabilitation services delivered to your residents are an investment in their future health and wellbeing. This concept was demonstrated in a collaborative analysis between FOX Rehabilitation and Optum Advisory Services, a third party Centers for Medicare and Medicaid Services (CMS) Qualified Entity. When risk adjusted, using the Hierarchical Condition Categories (HCC) model, FOX clients are 8.3% less costly to the healthcare system in the subsequent year, compared to the national benchmark of other outpatient providers.


Medicare's Hierarchical Condition Categories Risk Adjustment


2 1.5 1 0.93 0.5 0 FOX National Benchmark On average, HCC estimates a 75% higher cost for FOX clients


$16.5K $16K


$16,124 $15.5K FOX National Benchmark On average, FOX clients cost 8.3% less $18K 1.63


$17.5K $17K


$17,592


One Year Downstream Risk Adjusted Cost Variance


Optimal value is defined as better outcomes for lower cost. Partnering with a quality Medicare Part B provider within your community helps keep residents out of higher levels of care and in your community with improved Quality of Life (QOL). Healthcare costs are not only controlled, but significantly reduced for payers supporting the healthcare costs of your residents.


PHYSICAL, OCCUPATIONAL, & SPEECH THERAPY. FOX REHABILITATES LIVES. Tim Fox, PT, DPT, GCS-Emeritus, CCI, Lic. # 40QA00702100


HCC Risk Adjustment Related to Cost (Weighted Average of Top 9 CPT Codes)


Risk Adjusted One Year Downstream Cost (Weighted Average of Top 9 CPT codes)


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